Abstract 3604: Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) and Risk of Congestive Heart Failure in Older Adults: the Cardiovascular Health Study
Background: Congestive heart failure (CHF) is a major public health problem. Inflammation may be an underlying etiologic factor. Lp-PLA2 is an inflammation marker emerging as a vascular risk marker. One previous study showed an association of Lp-PLA2 activity with CHF risk, but there were less than 100 CHF cases and Lp-PLA2 antigen, which is available clinically in the U.S., was not measured. Whether Lp-PLA2 antigen and activity are risk factors for CHF is not clear.
Methods: We measured Lp-PLA2 antigen and activity in 3991 Cardiovascular Health Study participants (prospective observational study of men and women ≥65 years old) without CHF or cardiovascular disease at baseline. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CHF for each Lp-PLA2 quartile compared to the 1 st quartile. Models were first adjusted for age, sex, clinic site, and race (Model A). Additional adjustment included LDL, HDL, body mass index, systolic and diastolic blood pressure, hypertension, smoking status, pack-years, and diabetes (Model B). C-reactive protein (CRP) was added to evaluate the biological pathway of Lp-PLA2 and incident CHF (Model C).
Results: 756 participants developed CHF over 12.1 years of follow-up. Lp-PLA2 antigen, but not activity, was a risk factor for CHF. Adjustment for covariates, including CRP, had minimal impact on associations (Table⇓).
Conclusions: Lp-PLA2 antigen was a risk factor for future CHF in older people, independent of CHF risk factors and CRP. Further research is needed to better understand role of Lp-PLA2 in the development of CHF.